Angela Rene McQueary, DOC OF PHYSICAL THER
Individual provider Active NPI Physical Therapist · Rockwall, TX
NPI 1144590928 · NPPES record last updated Jan 10, 2012
Key facts
- NPI
- 1144590928
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 1207236 (TX)
- Practice address
- 930 W Ralph Hall Pkwy Ste 120
Rockwall, TX 75032-6664 - Phone
- (972) 771-0999
- Fax
- (972) 771-2281
- NPI assigned
- Jan 10, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1207236 | TX | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1207236 | TX | Yes |
Addresses
Primary practice location
930 W Ralph Hall Pkwy Ste 120
Rockwall, TX 75032-6664
Mailing address
930 W Ralph Hall Pkwy Ste 120
Rockwall, TX 75032-6664
Phone (972) 771-0999
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1207236 | Other | TX | LICENSE NUMBER |
Other providers in Rockwall, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.